Of course, taking your medication and following your doctor’s orders is one way to help ensure treatment effectiveness. But it’s equally important to pay attention to the lifestyle choices you make every day. Do you practice any of the following eight common habits? If so, follow the suggestions to swap those behaviors for other, healthier habits to help better manage your psoriatic arthritis.
1. Drinking too much alcohol
“Some patients notice that if they drink too much alcohol, they have a flare-up,” says Zhanna Mikulik, MD, an immunologist and rheumatologist who’s an assistant professor at Ohio State University’s Wexner Medical Center in Columbus. “Alcohol seems to trigger the release of molecules called cytokines, which worsen inflammation. Plus, alcohol is high in calories, and obesity exacerbates psoriatic arthritis.” What’s more, alcohol can cause liver damage, and some of the medications used to treat psoriatic arthritis can affect the liver as well. For all these reasons, it’s best to stay away from alcohol, Dr. Mikulik says. Instead, drink green tea: It contains compounds that may block the pro-inflammatory cytokine interleukin-1, keeping it from damaging cartilage in the joints, according to the Arthritis Foundation. “Second, the impact of being overweight on the weight-bearing joints will accelerate damage,” Dr. Goodman says. If you’re overweight, losing as little as 5 percent of your baseline weight can go a long way in controlling inflammation. To keep your weight in check, remember that a healthy body weight results from a balance between calories consumed and calories expended. “While there’s no easy solution to maintaining a healthy weight, portion control and exercise are the best sustainable methods,” Goodman says.
3. Embracing couch potato syndrome
Lack of exercise not only promotes weight gain but also makes joints stiffer and more immobile. “Exercise improves overall function and strengthens muscles, which helps stabilize the joints,” Mikulik says. Regular physical activity also keeps ligaments and tendons flexible and improves coordination; however, it’s important to do the right kinds of exercise. “Go for low-impact activities, such as walking, swimming, or water aerobics,” Mikulik suggests. When your joints are actively inflamed, temporarily put weight-bearing exercise on hold and opt for passive range-of-motion exercises and stretching until the inflammation subsides.
4. Eating red meat or other inflammation-promoting foods
Foods high in refined sugar, saturated fat, and trans fats cause the most inflammation. Skip these and “choose foods high in anti-inflammatory nutrients, including omega-3 fatty acids, selenium, and vitamin D,” Mikulik says. Good sources of omega-3s include salmon, mackerel, lake trout, albacore tuna, herring, and sardines, according to the American Heart Association. You can get selenium from Brazil nuts, fish, poultry, and eggs, the National Institutes of Health reports. For vitamin D, consume foods such as fatty fish and fortified milk. But foods might not provide enough D, so talk with your doctor about vitamin D supplements, Mikulik suggests. She adds that the evidence is limited regarding the effectiveness of selenium supplementation on psoriatic arthritis in adults.
5. Stressing out
“Stress can exacerbate psoriatic arthritis through a fairly complicated process that involves the immune system,” Mikulik says. For this reason, soon after a stressful event, people with psoriatic arthritis may experience a flare-up, she adds. To keep stress — and psoriatic arthritis symptoms — at bay, Mikulik recommends regular exercise, seven to nine hours of sleep a night, and meditation. “There’s also a link between psoriatic arthritis and depression, so if you are having depression symptoms, talk to your doctor,” she adds.
6. Lighting up
Although there isn’t a direct link between smoking and psoriatic arthritis, smoking is a risk factor for the condition, and smokers may not get the maximum effect of medications for psoriatic arthritis. Also, Mikulik notes that biologic medications may not work as well in smokers. Results of a study of 1388 people with psoriatic arthritis published in December 2015 in Annals of Rheumatic Diseases found that smokers had poorer response to TNF inhibitors than nonsmokers. Mikulik encourages her psoriatic arthritis patients to stop smoking.
7. Staying up all night
Everyone has a circadian rhythm, a 24-hour cycle during which certain hormones and cytokines are produced at certain times of the day. “When you don’t get enough sleep, this balance between hormones and cytokines gets disrupted, leading to inflammation,” Mikulik says. The National Sleep Foundation recommends that people who are 18 to 64 years old get seven to nine hours of sleep a night and adults over 64 snooze for seven to eight hours.
8. Throwing your hands in the air
Living with a chronic inflammatory condition can be overwhelming, but this doesn’t mean your hands are tied. A good first step to managing your psoriatic arthritis is to educate yourself about your condition, with the help of such resources as your doctor, the Arthritis Foundation, and the National Psoriasis Foundation. It’s also smart to get started right away on a regimen of medication, say Goodman. “It’s overwhelming to try to quit smoking and lose weight while you feel exhausted and are in pain from unchecked inflammation,” she says. “Once patients begin treatment and feel better, they find other goals less challenging.” Additional reporting by Susan Jara
